The Rural Healthcare Quality Network (RHQN) of Washington State and American Institutes for Research (AIR) have joined forces to demonstrate the value of HIT in improving the quality of emergency and inpatient care in rural hospitals by facilitating the adoption of national clinical guidelines and their adaptation to rural settings. This project will conduct a quasi-experimental evaluation of a Rural Health Information Technology Cooperative (RHITC), based in network computing, designed to improve the practice patterns of physicians and nurses in two clinical areas that are particularly relevant to rural hospital practice: emergency department (ED) stabilization of acute myocardial infarction (AMI) patients and inpatient care of patients with community-acquired pneumonia (CAP). The project's broad goal is to demonstrate the value and foster the widespread deployment of HIT to promote rural clinical best practices and overcome barriers to the adoption of quality-improvement innovations in rural hospitals. The project's specific objectives are to: 1. Design and implement the RHITC intervention: (a) identify rural best clinical practices for AMI and CAP, based on national guidelines; and (b) develop appropriate HIT interventions to achieve standardized adoption of these best practices in each of the hospitals exposed to the intervention. 2. Network and hospital-level evaluation: Examine (a) how the characteristics of rural hospitals impede or facilitate the adoption of the HIT intervention; and (b) how the intervention influences hospital culture and performance. 3. Staff-level evaluation: Determine the impact of the HIT intervention on physician, mid-level practitioner, and nurse knowledge, attitudes, behavior, and practice culture in rural hospitals. 4. Patient-level evaluation: Examine the associations between the use of the HIT intervention by hospital staff and quality of hospital care and utilization of hospital services. 5. Disseminate the results: Disseminate the HIT intervention model for use by small rural hospitals nationwide.